The description of the interventions was adequate. The authors reported some evidence to justify their selection of these treatments, but the evidence was not fully described and other important options could have been omitted.
The effectiveness data were poorly reported. The methods used to identify the relevant studies were not described, nor were the methods used to select these sources, making it difficult to assess if the best available evidence was included in the model. No details of the clinical studies were given, so no assessment of internal validity can be made.
The included cost categories were relevant to the perspective, but it was not clear whether all the costs were included, such as those for the treatment of adverse events. The sources for the resource and cost data were provided, but the detail was insufficient to assess the quality of methods. The cost adjustment technique was reported, but further information was needed to assess whether or not correct methods were used. The authors made adjustments using the consumer price index, but the health care component of the consumer price index would have been more appropriate. The description of the cost data was adequate, but more detail would have been useful.
Analysis and results:
An incremental analysis was appropriate for comparing the relative cost-effectiveness of the alternative treatments, but the results were very poorly reported. The authors attempted to assess the impact of uncertainty on the results, but they did not fully consider the joint impact of multiple parameter uncertainty. The reporting of the analysis was poor, limiting the ability to compare the treatments. The authors discussed some of the limitations of their analysis, but the poor reporting makes any assessment of the validity of their analysis difficult.
The study was not well reported, so it is not possible to fully assess the analysis and the authors’ conclusions.